
The
liver is the largest gland in the vertebrate body, composed of a spongy mass
of wedge-shaped lobes that has many metabolic and secretory functions.
It is a reddish-brown in color and is located in the upper right part of the
abdominal cavity extending 3-4 inches to the left of the midline. It weighs
about three pounds and is approximately 3-5% fat. It performs over 500
functions.
Here's an amazing fact about the liver, and it makes it's importance more clear:
With only 1/6th of your liver
present your body could continue to function. Another interesting fact: as much as 80% of your liver
could be cut away and it would grow back
to a full size in approximately three months. Because the liver is designed
in this way, it is usually hard to determine if the liver is damaged until
the damage is quite advanced.
To perform many of its varied functions, the liver is uniquely and closely
connected with both the intestine and the
gallbladder. From the intestine
the portal vein carries venous blood to the liver to be processed before
returning to the heart. From the liver a duct system carries
bile to the common bile duct,
which empties into the duodenum of the intestine and which connects with the gallbladder for storage and
subsequent release of bile.
Liver
tissue consists of a mass of cells tunneled through with bile ducts and
blood vessels. Hepatic (liver) cells make up about 60 percent of the tissue
and carry on more metabolic functions than any other group of cells in the
body. A second group of cells, called Kupffer cells,
line the smallest channels of the liver's vascular system and play a role in
blood formation, antibody production, and ingestion of foreign particles and
cellular debris.
The human liver secretes about 800 to 1,000
millilitres (about a quart) each day of bile, which contains bile salts
needed for the digestion of fats in the diet. Bile is also the medium for
excretion of certain metabolic waste products, drugs, and toxic substances.
Bile secreted into the common bile duct enters the gallbladder, where it is
concentrated and stored. The presence of fat in the duodenum stimulates the
flow of bile out of the gallbladder and into the intestine. Worn-out red
blood cells are destroyed in the liver, spleen, and bone marrow. A pigment,
bilirubin, formed in the process of hemoglobin breakdown, is
released into the bile, creating its characteristic greenish-orange colour,
and is excreted from the body through the intestine.
The liver cells synthesize a number of enzymes. As
blood flows through the liver, both from the portal vein and from the
hepatic artery, the cells and enzymes filter out and modify many substances
and particles. Nutrients entering the liver from the intestine are changed
into forms usable by the body cells or are stored for future use. Fats are
converted into
fatty acids and then into
carbohydrates
or ketone bodies and transported by the blood to the tissues, where they are
further metabolized. Sugars are converted into
glycogen,
which remains stored in the liver until it is needed for energy production,
when it is reconverted into glucose and released into the bloodstream. The
liver manufactures blood serum proteins, including albumin and several
clotting factors, and supplies them to the blood. In its role as a blood
purifier, the liver metabolizes nitrogenous waste products from body
processes and detoxifies poisonous substances, preparing them for
elimination in the urine or feces.
A common sign of impaired liver function is
jaundice, a yellowness of the eyes and skin arising from excessive bilirubin
in the blood. Jaundice can result from an abnormally high level of red blood
cell destruction (hemolytic (referring to destruction of red blood cells)
jaundice), defective uptake or transport of bilirubin by the hepatic cells
(hepatocellular jaundice), or a blockage in the bile duct system
(obstructive jaundice). Failure of hepatic cells to function can result from {hepatitis} hepatitis,
cirrhosis, tumors,
vascular obstruction, or poisoning. Symptoms may include weakness, low blood
pressure, easy bruising and bleeding, tremor, apathy, brain wave changes,
and accumulation of fluid in the abdomen. Tests of liver function help in
identifying disease, estimating liver damage, and evaluating treatment.
Blood tests can reveal abnormal levels of bilirubin, cholesterol, serum
proteins, urea, ammonia, and various enzymes. Injecting the dye
bromsulfalein (BSP) and measuring its time of retention in the blood is
another gauge of liver function. The condition of liver tissue can be
examined microscopically by performing a needle biopsy.
Acute viral hepatitis is an inflammation of the
liver that includes
{hepatitis} hepatitis A, usually spread by fecal contamination of food or drink,
and
{hepatitis} hepatitis B, commonly transmitted by injection with unsterile
instruments or by transfusion of contaminated blood or plasma. A third
category of viral hepatitis, called
{hepatitis} non-A,
non-B hepatitis, is caused by at least one (and probably two) other viral
agents. Non-A, non-B infection is a common cause of posttransfusion
hepatitis. In all forms of viral hepatitis, the illness may last two to six
weeks, and fatigue often persists for as long as six months. The disease is
ordinarily self-limiting; treatment includes bed rest and abstention from
alcohol. Prevention of outbreaks requires careful sanitation as well as
sterile injection and transfusion procedures.
Cirrhosis of the liver is an irreversible chronic disease
characterized by the replacement of functioning liver tissue with bands and
lumps of scar tissue. It can be brought about by viral hepatitis, chronic
alcoholism, obstruction of the bile channels or the hepatic vein, heart
failure, deposition of iron or copper, or some forms of metabolic disease.
Cirrhosis causes hepatic cell failure and abnormally high pressure in the
portal vein, leading to enlargement of the spleen and rupture of blood
vessels. Treatment requires eliminating the primary cause, if possible. An
alcoholic with cirrhosis, for example, can show striking improvement with
bed rest and total avoidance of alcohol.
The liver is subject to a variety of other disorders
and diseases. Abscesses can be caused by acute appendicitis; those occurring
in the bile ducts may result from gallstones or may follow surgery. The
parasite that causes amebic dysentery in the tropics can produce
liver abscesses as well. Various other parasites prevalent in different
parts of the world also infect the liver. Cancers of the liver are common,
most of them secondary tumours originating elsewhere in the body.
Glycogen-storage diseases, a group of hereditary disorders, generate a
buildup of glycogen in the liver and an insufficient supply of glucose in
the blood. Certain drugs may damage the liver, producing jaundice.
More detailed information about liver function can be found
here.
|
Alkaline phosphatase |
An enzyme produced in the liver, bone, and placenta that is released into the blood during injury or during such normal activities as bone growth or pregnancy |
Bile duct obstruction, liver injury, and some cancers |
| Alanine transaminase (ALT) | An enzyme produced in the liver that is released into the blood when liver cells are injured |
Liver cell injury (as in hepatitis) |
| Aspartate transaminase (AST) | An enzyme released into the blood when the liver, heart, muscle, or brain is injured |
Injury to liver, heart, muscles, or brain |
Bilirubin | A component of the digestive juice (bile) produced by the liver | Obstruction to bile outflow, liver damage, excessive breakdown of red blood cells (from which bilirubin is made) |
| Gamma-glutamyl transpeptidase | An enzyme produced by the liver, pancreas, and kidneys and released into the blood when these organs are injured | Organ damage, drug toxicity, alcohol abuse, disease of the pancreas |
| Lactic dehydrogenase | An enzyme released into the blood when certain organs are injured | Damage to the liver, heart, lung, or brain and excessive breakdown of red blood cells |
5'-nucleotidase | An enzyme contained only in the liver and released into the blood when the liver is injured | Bile duct obstruction or impaired bile flow |
Albumin | A protein produced by the liver and normally released into the blood; one of albumin's functions is to hold fluid inside the blood vessels |
Liver damage |
| Alpha-fetoprotein | A protein produced by the fetal liver and testes | Severe hepatitis or cancer of the liver or testes |
| Mitochondrial antibodies | Circulating antibodies against mitochondria, an inner component of cells | Primary biliary cirrhosis and certain autoimmune diseases,such as chronic active hepatitis |
Prothrombin time | Time needed for blood to clot (clotting requires vitamin K and substances made by the liver) | Liver damage or poor absorption of vitamin K caused by a lack of bile |
|
Liver function tests are performed on blood samples. Most tests measure the levels of enzymes or other substances in the blood as a way of diagnosing liver problems. One test measures the time needed for blood to clot. |
The following reflexes are used to test the liver:
These reflexes should be tested and treated
with the proper supplementation.

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